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FINALS - CHILD HEALTH > neonatal GI > Flashcards

neonatal GI Flashcards

1
Q

what is meconium aspiration

A

resp distress in newborn from meconium in trachea

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2
Q

RF meconium aspiration

A

post term // resp distress // maternal hypertension, pre-eclampsia, chorioamnionitis, smoking, substance abuse

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3
Q

what is bilious vomiting

A

bile eg green or yellow

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4
Q

causes bilious vomiting neonates

A

duodenal, jejunal atresia // malrotation with volvulus // meconium ileus // nec enterocolitis

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5
Q

features deodenal atresia

A

downs // present just after birth with vomiting

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6
Q

inxv + mx deodenal atresia

A

AXR = double bubble // Duodenoduodenostomy

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7
Q

presentation intestinal Malrotation with volvulus

A

3-7 days post birth // peritonism + haemodynamically unstable // vomiting // high caecum

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8
Q

classic presentation intestinal malrotation

A

bilious vomiting + obstruction

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9
Q

inxv intestinal Malrotation +/- volvulus

A

upper GI contrast + USS

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10
Q

mx intestinal Malrotation +/- volvulus

A

no volvulus = lap // with volvulus = ladd procedure

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11
Q

presentation meconeum ileus

A

CF // 24-48 hours of life // abdo distension, vomitting

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12
Q

what causes pyloric stenosis

A

hypertrophy of muscles of pylorus

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13
Q

RF pyloric stenosis

A

males // FH // first borns

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14
Q

features pyloric stenosis

A

2-4 weeks old // projectile vomiting after feed // dehydration + consipated // palpable mass

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15
Q

metabolic changes pyloric stenosis

A

hypoCl, hypoK, alkalosis

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16
Q

invx + mx pyloric stenosis

A

USS –> Ramstedt pyloromyotomy.

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17
Q

age and demographic intussusception

A

boys 16-18 months

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18
Q

features intussusception

A

severe, crampy abdo pain // mass // crying ++ // draw knees up and go pale // red current jelly in stool // vomiting

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19
Q

invx intussusception

A

USS –> target

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20
Q

mx intussusception

A

air into rectum –> surgery

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21
Q

what is hisrchprungs disease

A

no parasympathetic development to bowel –> functional obstruction

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22
Q

presentation hisrchprungs

A

boys // downs // neonatal failure to pass meconium // constipation

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23
Q

invx hisrchprungs

A

abdo xray // rectal biopsy = gold standard

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24
Q

mx hisrchprungs

A

rectal washout or irrigation –> definitive surgery

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25
Q

types of biliary atresia

A

1 = only common bile duct affected // 2= atresia of cystic duct + hepatic duct // 3 = atresia of the left and right ducts to the level of the porta hepatis (90%)

26
Q

presentation biliary atresia

A

fist few weeks // jaundice >2 weeks long // dark urine + pale stools // reduced appetite and growth // haepatosplenomegaly

27
Q

invx biliary atresia

A

normal total bilirubin, raised conjugated bilirubin (dark urine) // raised AST // serum a1 deficiency // sweat test (CF) // USS

28
Q

mx biliary atresia

A

surgery

29
Q

complications biliary atresia

A

anastomosis, liver disease –> cirrhosis –> hepatocellular carcinoma

30
Q

who is at risk of Necrotising enterocolitis

A

preterms – death !!

31
Q

symptoms Necrotising enterocolitis

A

reduced feeding // abdo distension + bloody stool // perforation, peritonitis

32
Q

invx Necrotising enterocolitis

A

abdo Xray: dilated loops, pneumatosis intestinalis (intramural gas)!!!, oedema

33
Q

presentation colic

A

<3 months // crying, pulling legs, worse in evening

34
Q

mx colic

A

NO simeticone or lactase

35
Q

features cows milk allergy

A

<3 months // formula fed baby // regurg + vomiting // diarrhoea // urticaria or eczema // colic // wheeze

36
Q

diagnosis cows allergy

A

skin prick or patch // RAST IgE

37
Q

mx cows allergy

A

extensive hydrolysed formula if formula fed // continue breastfeeding if breastfed, reduce cow milk from maternal diet, ca supplement

38
Q

which type of cows milk allergy grow out of it

A

non IgE by age 3

39
Q

common hernias in children

A

umbilical, inguinal diapgramatic

40
Q

where do umbilical hernias appear

A

symmetrical bulge under umbilicus

41
Q

assoc umbilical hernias

A

black!! // downs,

42
Q

mx umbilical hernias

A

resolve before age 4-5

43
Q

assoc congenital inguinal hernia

A

premature males

44
Q

where do inguinal hernias appear

A

60% right sided

45
Q

what can cause inguinal hernia kids

A

patent processus vaginalis may persist

46
Q

mx inguinal hernia kids

A

surgically repair to reduce risk of incarceration

47
Q

what is a Congenital diaphragmatic hernia

A

incomplete closure of pleurperitoneal canal (diaphragm) –> herniation of abdominal viscera –> chest

48
Q

symptoms Congenital diaphragmatic hernia

A

pulmonary hypoplasia and hypertension –> resp distress

49
Q

most common Congenital diaphragmatic hernia

A

left-sided posterolateral Bochdalek

50
Q

survival congenital diaphragm hernia

A

50%

51
Q

what is meckels diverticulum

A

congenital diverticulum of small intestine // remnant of omphalomesenteric duct

52
Q

rule of 2 meckels diverticulum

A

2% population // 2 feet from ileocaecal valve // 2 inches long

53
Q

symptoms meckels diverticulum

A

usually asymptomatic abdo pain // massive GI bleed age 1-2!!!! // obstruction

54
Q

invx meckels diverticulum

A

stable = meckles technetium scan // severe = mesenteric arteriography

55
Q

meckels diverticulum mx

A

removal if narrow neck

56
Q

what are Gastroschisis and exomphalos

A

congenital visceral malformations.

57
Q

what is Gastroschisis

A

defect in anterior ando wall just lateral to umbilicus

58
Q

mx Gastroschisis

A

vaginal delivery ok –> theatre straight away

59
Q

what is Exomphalos

A

abdo contents protrude out of anterior abdo wall but covered by protective membrane

60
Q

mx Exomphalos

A

C section + staged repair

FINALS - CHILD HEALTH (16 decks)

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